A six-week stay at a Hindu temple in Tamil Nadu can produce the same improvement in people with severe psychiatric disorders as a month-long course of standard drugs, say researchers in India. The study was conducted at the temple of Muthuswamy in South India, known as a source of help for people with serious mental disorders.

A team led by Ramanathan Raguram of the National Institute of Mental Health and Neurosciences in Bangalore studied all 31 people who came for help and stayed at the Muthuswamy temple in Velayuthampalayampudur between June and August 2000. Twenty three were diagnosed with paranoid schizophrenia, six with delusional disorders, and two with bipolar disorder. No specific ceremonies to promote the recovery of patients are performed at the temple. Instead the patient is encouraged to take part in the daily maintenance routines of the temple.

"What they were given is tender loving care, in a non-threatening environment, in tune with their own cultural beliefs, with the hope of recovery," says Raguram. "And in the history of psychiatry, these were the principles on which asylums were originally built."

Everyone who came for help was assessed by a trained psychiatrist on the first day of their stay in the temple and again on the day they left to return home, using recognised psychiatric rating scale scores. Family caregivers were also asked to assess satisfaction with their experience at the temple.

Curative powers

In India, many mentally ill people of all faiths visit religious sites renowned for having curative powers. The Muthuswamy temple is built over the tomb of a man who lived a century ago and who, according to legend, could cure mental illnesses with a touch of his hand. His descendants now run the temple and offer its services for free.

The 31 patients had been suffering for an average of 71 weeks. Only one had received any professional care.

The researchers found a reduction of nearly 20% in psychiatric rating scale scores, representing a level of clinical improvement that matches that achieved by many psychotrophic drugs. Family caregivers also thought that most of the patients had improved during their stay. In the absence of any specific healing rituals, the observed benefits appeared to result from a supportive, non-threatening environment, say the authors. They suggest that these institutions may have a role in providing community mental health care.

The dramatic improvement in test scores matches those expected within four weeks of administering drugs such as chlorpromazine and risperidone, says Raguram. "We were not really prepared for it," he says.

Complementary approach

Assen Jablensky, an expert on mental disorders at the University of Western Australia, Perth, points out that such findings are not specific to India, or any particular faith. "For example, a 'treatment protocol' in many ways similar to the healing temple of Muthuswamy has been practised at the traditional therapeutic village of Aro in Nigeria," he says.

But he cautions that such treatments should be considered as complementary to other approaches, and not an alternative.

Raguram admits one problem with the study - there were no controls. "To prove the efficacy we need double-blind control studies, which is very difficult to conduct in such settings," he says.